Senate Bill 2148

AN ACT TO AMEND SECTION 25-15-9, MISSISSIPPI CODE OF 1972,
TO REQUIRE COVERAGE FOR HYPERBARIC OXYGEN THERAPY FOR CHILDREN WITH CEREBRAL
PALSY UNDER THE STATE AND SCHOOL EMPLOYEES HEALTH INSURANCE PLAN; AND FOR
RELATED PURPOSES.

[Through June 30 of the year in which
Section 25-11-143 becomes effective as provided in subsection (1) of Section 25-11-143,
this section shall read as follows:]

25-15-9.
(1) (a) The board shall design a plan of health
insurance for state employees which provides benefits for semiprivate rooms in
addition to other incidental coverages which the board deems necessary. The amount of the coverages shall be in such
reasonable amount as may be determined by the board to be adequate, after due
consideration of current health costs in Mississippi. The plan shall also include major medical benefits in such
amounts as the board shall determine. The board is also authorized to accept bids for such alternate
coverage and optional benefits as the board shall deem proper. Any contract for alternative coverage and
optional benefits shall be awarded by the board after it has carefully studied
and evaluated the bids and selected the best and most cost-effective bid. The board may reject all such bids; however,
the board shall notify all bidders of the rejection and shall actively solicit
new bids if all bids are rejected. The
board may employ or contract for such consulting or actuarial services as may
be necessary to formulate the plan, and to assist the board in the preparation
of specifications and in the process of advertising for the bids for the
plan. Such contracts shall be solicited
and entered into in accordance with Section 25-15-5. The board shall keep a record of all persons, agents and
corporations who contract with or assist the board in preparing and developing
the plan. The board in a timely manner
shall provide copies of this record to the members of the advisory council
created in this section and those legislators, or their designees, who may
attend meetings of the advisory council.
The board shall provide copies of this record in the solicitation of
bids for the administration or servicing of the self-insured program. Each person, agent or corporation which,
during the previous fiscal year, has assisted in the development of the plan or
employed or compensated any person who assisted in the development of the plan,
and which bids on the administration or servicing of the plan, shall submit to
the board a statement accompanying the bid explaining in detail its
participation with the development of the plan. This statement shall include the amount of compensation paid by
the bidder to any such employee during the previous fiscal year. The board shall make all such information
available to the members of the advisory council and those legislators, or
their designees, who may attend meetings of the advisory council before any
action is taken by the board on the bids submitted. The failure of any bidder to fully and accurately comply with
this paragraph shall result in the rejection of any bid submitted by that
bidder or the cancellation of any contract executed when the failure is discovered
after the acceptance of that bid. The
board is authorized to promulgate rules and regulations to implement the
provisions of this subsection.

The board shall develop plans for the
insurance plan authorized by this section in accordance with the provisions of
Section 25-15-5.

Any corporation, association, company or
individual that contracts with the board for the third-party claims
administration of the self-insured plan shall prepare and keep on file an
explanation of benefits for each claim processed. The explanation of benefits shall contain such information
relative to each processed claim which the board deems necessary, and, at a
minimum, each explanation shall provide the claimant's name, claim number,
provider number, provider name, service dates, type of services, amount of
charges, amount allowed to the claimant and reason codes. The information contained in the explanation
of benefits shall be available for inspection upon request by the board. The board shall have access to all claims
information utilized in the issuance of payments to employees and providers.

(b)
There is created an advisory council to advise the board in the
formulation of the State and School Employees Health Insurance Plan. The council shall be composed of the State
Insurance Commissioner or his designee, an employee-representative of the
institutions of higher learning appointed by the board of trustees thereof, an
employee-representative of the Department of Transportation appointed by the
director thereof, an employee-representative of the State Tax Commission
appointed by the Commissioner of Revenue, an employee-representative of the
Mississippi Department of Health appointed by the State Health Officer, an
employee-representative of the Mississippi Department of Corrections appointed
by the Commissioner of Corrections, and an employee-representative of the
Department of Human Services appointed by the Executive Director of Human
Services, two (2) certificated public school administrators appointed by the State
Board of Education, two (2) certificated classroom teachers appointed by the
State Board of Education, a noncertificated school employee appointed by the
State Board of Education and a community/junior college employee appointed by
the State Board for Community and Junior Colleges.

The Lieutenant Governor may designate the
Secretary of the Senate, the Chairman of the Senate Appropriations Committee,
the Chairman of the Senate Education Committee and the Chairman of the Senate
Insurance Committee, and the Speaker of the House of Representatives may
designate the Clerk of the House, the Chairman of the House Appropriations
Committee, the Chairman of the House Education Committee and the Chairman of
the House Insurance Committee, to attend any meeting of the State and School
Employees Insurance Advisory Council.
The appointing authorities may designate an alternate member from their
respective houses to serve when the regular designee is unable to attend such
meetings of the council. Such designees
shall have no jurisdiction or vote on any matter within the jurisdiction of the
council. For attending meetings of the
council, such legislators shall receive per diem and expenses which shall be
paid from the contingent expense funds of their respective houses in the same
amounts as provided for committee meetings when the Legislature is not in
session; however, no per diem and expenses for attending meetings of the
council will be paid while the Legislature is in session. No per diem and expenses will be paid except
for attending meetings of the council without prior approval of the proper
committee in their respective houses.

(c)
No change in the terms of the State and School Employees Health
Insurance Plan may be made effective unless the board, or its designee, has
provided notice to the State and School Employees Health Insurance Advisory
Council and has called a meeting of the council at least fifteen (15) days
before the effective date of such change.
In the event that the State and School Employees Health Insurance
Advisory Council does not meet to advise the board on the proposed changes, the
changes to the plan shall become effective at such time as the board has
informed the council that the changes shall become effective.

(d) Medical benefits for retired
employees and dependents under age sixty-five (65) years and not eligible for
Medicare benefits. The same health
insurance coverage as for all other active employees and their dependents shall
be available to retired employees and all dependents under age sixty-five (65)
years who are not eligible for Medicare benefits, the level of benefits to be
the same level as for all other active participants. This section will apply to those employees who retire due to one
hundred percent (100%) medical disability as well as those employees electing
early retirement.

(e) Medical
benefits for retired employees and dependents over age sixty-five (65) years or
otherwise eligible for Medicare benefits.
The health insurance coverage available to retired employees over age
sixty-five (65) years or otherwise eligible for Medicare benefits, and all
dependents over age sixty-five (65) years or otherwise eligible for Medicare
benefits, shall be the major medical coverage with the lifetime maximum of One
Million Dollars ($1,000,000.00).
Benefits shall be reduced by Medicare benefits as though such Medicare
benefits were the base plan.

All covered individuals shall be assumed to
have full Medicare coverage, Parts A and B; and any Medicare payments under
both Parts A and B shall be computed to reduce benefits payable under this
plan.

(2)
Nonduplication of benefits--reduction of benefits by Title XIX
benefits: When benefits would be
payable under more than one (1) group plan, benefits under those plans will be
coordinated to the extent that the total benefits under all plans will not
exceed the total expenses incurred.

Benefits for hospital or surgical or
medical benefits shall be reduced by any similar benefits payable in accordance
with Title XIX of the Social Security Act or under any amendments thereto, or
any implementing legislation.

Benefits for hospital or surgical or
medical benefits shall be reduced by any similar benefits payable by workers'
compensation.

(3) Beginning on July 1, 2005, the board
shall provide that the plan include coverage for hyperbaric oxygen therapy for
children with cerebral palsy. The
benefit provided in this subsection shall be subject to the same annual
deductibles or coinsurance established for all other covered benefits within
the plan.

(4)
(a) Schedule of life insurance
benefits--group term: The amount of
term life insurance for each active employee of a department, agency or
institution of the state government shall not be in excess of One Hundred
Thousand Dollars ($100,000.00), or twice the amount of the employee's annual
wage to the next highest One Thousand Dollars ($1,000.00), whichever may be
less, but in no case less than Thirty Thousand Dollars ($30,000.00), with a
like amount for accidental death and dismemberment on a twenty-four-hour
basis. The plan will further contain a
premium waiver provision if a covered employee becomes totally and permanently
disabled prior to age sixty-five (65) years.
Employees retiring after June 30, 1999, shall be eligible to continue
life insurance coverage in an amount of Five Thousand Dollars ($5,000.00), Ten
Thousand Dollars ($10,000.00) or Twenty Thousand Dollars ($20,000.00) into
retirement.

(b)
Effective October 1, 1999, schedule of life insurance benefits--group
term: The amount of term life insurance
for each active employee of any school district, community/junior college,
public library or university-based program authorized under Section 37-23-31
for deaf, aphasic and emotionally disturbed children or any regular nonstudent
bus driver shall not be in excess of One Hundred Thousand Dollars
($100,000.00), or twice the amount of the employee's annual wage to the next
highest One Thousand Dollars ($1,000.00), whichever may be less, but in no case
less than Thirty Thousand Dollars ($30,000.00), with a like amount for
accidental death and dismemberment on a twenty-four-hour basis. The plan will further contain a premium
waiver provision if a covered employee of any school district, community/junior
college, public library or university-based program authorized under Section 37-23-31
for deaf, aphasic and emotionally disturbed children or any regular nonstudent
bus driver becomes totally and permanently disabled prior to age sixty-five
(65) years. Employees of any school district,
community/junior college, public library or university-based program authorized
under Section 37-23-31 for deaf, aphasic and emotionally disturbed children or
any regular nonstudent bus driver retiring after September 30, 1999, shall be
eligible to continue life insurance coverage in an amount of Five Thousand
Dollars ($5,000.00), Ten Thousand Dollars ($10,000.00) or Twenty Thousand
Dollars ($20,000.00) into retirement.

(5)
Any eligible employee who on March 1, 1971, was participating in a group
life insurance program which has provisions different from those included
herein and for which the State of Mississippi was paying a part of the premium
may, at his discretion, continue to participate in such plan. Such employee shall pay in full all additional
costs, if any, above the minimum program established by this article. Under no circumstances shall any individual
who begins employment with the state after March 1, 1971, be eligible for the
provisions of this paragraph.

(6)
The board may offer medical savings accounts as defined in Section 71-9-3
as a plan option.

(7)
Any premium differentials, differences in coverages, discounts
determined by risk or by any other factors shall be uniformly applied to all
active employees participating in the insurance plan. It is the intent of the Legislature that the state contribution
to the plan be the same for each employee throughout the state.

(8)
On October 1, 1999, any school district, community/junior college
district or public library may elect to remain with an existing policy or
policies of group life insurance with an insurance company approved by the
State and School Employees Health Insurance Management Board, in lieu of
participation in the State and School Life Insurance Plan. On or after July 1, 2004, until October 1,
2004, any school district, community/junior college district or public library
may elect to choose a policy or policies of group life insurance existing on
October 1, 1999, with an insurance company approved by the State and School
Employees Health Insurance Management Board in lieu of participation in the
State and School Life Insurance Plan.
The state's contribution of up to fifty percent (50%) of the active
employee's premium under the State and School Life Insurance Plan may be
applied toward the cost of coverage for full-time employees participating in
the approved life insurance company group plan. For purposes of this subsection (8), "life insurance
company group plan" means a plan administered or sold by a private insurance
company. After October 1, 1999, the
board may assess charges in addition to the existing State and School Life
Insurance Plan rates to such employees as a condition of enrollment in the
State and School Life Insurance Plan.
In order for any life insurance company group planto be approved by the State and School Employees Health Insurance
Management Board under this subsection (8), it shall meet the following
criteria:

(a)
The insurance company offering the group life insurance plan shall be
rated "A-" or better by A.M. Best state insurance rating service and
be licensed as an admitted carrier in the State of Mississippi by the
Mississippi Department of Insurance.

(b)
The insurance company group life insurance plan shall provide the same
life insurance, accidental death and dismemberment insurance and waiver of
premium benefits as provided in the State and School Life Insurance Plan.

(c)
The insurance company group life insurance plan shall be fully insured,
and no form of self-funding life insurance by such company shall be approved.

(d)
The insurance company group life insurance plan shall have one (1)
composite rate per One Thousand Dollars ($1,000.00) of coverage for active
employees regardless of age and one (1) composite rate per One Thousand Dollars
($1,000.00) of coverage for all retirees regardless of age or type of retiree.

(e)
The insurance company and its group life insurance plan shall comply
with any administrative requirements of the State and School Employees Health
Insurance Management Board. In the
event any insurance company providing group life insurance benefits to
employees under this subsection (8) fails to comply with any
requirements specified herein or any administrative requirements of the board,
the state shall discontinue providing funding for the cost of such insurance.

[From and after July 1 of the year in which
Section 25-11-143 becomes effective as provided in subsection (1) of Section 25-11-143,
this section shall read as follows:]

25-15-9.
(1) (a) The board shall design a plan of health
insurance for state employees that provides benefits for semiprivate rooms in
addition to other incidental coverages that the board deems necessary. The amount of the coverages shall be in such
reasonable amount as may be determined by the board to be adequate, after due
consideration of current health costs in Mississippi. The plan shall also include major medical benefits in such
amounts as the board shall determine.
The board is also authorized to accept bids for such alternate coverage
and optional benefits as the board deems proper. Any contract for alternative coverage and optional benefits shall
be awarded by the board after it has carefully studied and evaluated the bids
and selected the best and most cost-effective bid. The board may reject all such bids; however, the board shall
notify all bidders of the rejection and shall actively solicit new bids if all
bids are rejected. The board may employ
or contract for such consulting or actuarial services as may be necessary to
formulate the plan, and to assist the board in the preparation of
specifications and in the process of advertising for the bids for the
plan. Those contracts shall be
solicited and entered into in accordance with Section 25-15-5. The board shall keep a record of all
persons, agents and corporations who contract with or assist the board in
preparing and developing the plan. The
board in a timely manner shall provide copies of this record to the members of
the advisory council created in this section and those legislators, or their
designees, who may attend meetings of the advisory council. The board shall provide copies of this
record in the solicitation of bids for the administration or servicing of the
self-insured program. Each person,
agent or corporation that, during the previous fiscal year, has assisted in the
development of the plan or employed or compensated any person who assisted in
the development of the plan, and that bids on the administration or servicing
of the plan, shall submit to the board a statement accompanying the bid
explaining in detail its participation with the development of the plan. This statement shall include the amount of
compensation paid by the bidder to any such employee during the previous fiscal
year. The board shall make all such
information available to the members of the advisory council and those
legislators, or their designees, who may attend meetings of the advisory
council before any action is taken by the board on the bids submitted. The failure of any bidder to fully and
accurately comply with this paragraph shall result in the rejection of any bid
submitted by that bidder or the cancellation of any contract executed when the
failure is discovered after the acceptance of that bid. The board is authorized to promulgate rules
and regulations to implement the provisions of this subsection.

The board shall develop plans for the
insurance plan authorized by this section in accordance with the provisions of
Section 25-15-5.

Any corporation, association, company or
individual that contracts with the board for the third-party claims
administration of the self-insured plan shall prepare and keep on file an
explanation of benefits for each claim processed. The explanation of benefits shall contain such information
relative to each processed claim which the board deems necessary, and, at a
minimum, each explanation shall provide the claimant's name, claim number,
provider number, provider name, service dates, type of services, amount of
charges, amount allowed to the claimant and reason codes. The information contained in the explanation
of benefits shall be available for inspection upon request by the board. The board shall have access to all claims
information utilized in the issuance of payments to employees and providers.

(b)
There is created an advisory council to advise the board in the
formulation of the State and School Employees Health Insurance Plan. The council shall be composed of the State
Insurance Commissioner or his designee, an employee-representative of the state
institutions of higher learning appointed by the board of trustees thereof, an
employee-representative of the Mississippi Department of Transportation
appointed by the director thereof, an employee-representative of the State Tax
Commission appointed by the Commissioner of Revenue, an employee-representative
of the State Department of Health appointed by the State Health Officer, an
employee-representative of the Mississippi Department of Corrections appointed
by the Commissioner of Corrections, and an employee-representative of the
Mississippi Department of Human Services appointed by the Executive Director of
Human Services, two (2) certificated public school administrators appointed by
the State Board of Education, two (2) certificated classroom teachers appointed
by the State Board of Education, a noncertificated school employee appointed by
the State Board of Education and a community/junior college employee appointed
by the State Board for Community and Junior Colleges.

The Lieutenant Governor may designate the
Secretary of the Senate, the Chairman of the Senate Appropriations Committee,
the Chairman of the Senate Education Committee and the Chairman of the Senate
Insurance Committee, and the Speaker of the House of Representatives may
designate the Clerk of the House, the Chairman of the House Appropriations
Committee, the Chairman of the House Education Committee and the Chairman of
the House Insurance Committee, to attend any meeting of the State and School
Employees Insurance Advisory Council.
The appointing authorities may designate an alternate member from their
respective houses to serve when the regular designee is unable to attend such
meetings of the council. Those
designees shall have no jurisdiction or vote on any matter within the
jurisdiction of the council. For
attending meetings of the council, those legislators shall receive per diem and
expenses, which shall be paid from the contingent expense funds of their respective
houses in the same amounts as provided for committee meetings when the
Legislature is not in session; however, no per diem and expenses for attending
meetings of the council will be paid while the Legislature is in session. No per diem and expenses will be paid except
for attending meetings of the council without prior approval of the proper
committee in their respective houses.

(c)
No change in the terms of the State and School Employees Health
Insurance Plan may be made effective unless the board, or its designee, has
provided notice to the State and School Employees Health Insurance Advisory
Council and has called a meeting of the council at least fifteen (15) days
before the effective date of the change.
If the State and School Employees Health Insurance Advisory Council does
not meet to advise the board on the proposed changes, the changes to the plan
will become effective at such time as the board has informed the council that
the changes will become effective.

(2)
Nonduplication of benefits--reduction of benefits by Title XIX benefits: When benefits would be payable under more
than one (1) group plan, benefits under those plans will be coordinated to the
extent that the total benefits under all plans will not exceed the total
expenses incurred.

Benefits for hospital or surgical or
medical benefits shall be reduced by any similar benefits payable in accordance
with Title XIX of the Social Security Act or under any amendments thereto, or
any implementing legislation.

Benefits for hospital or surgical or
medical benefits shall be reduced by any similar benefits payable by workers'
compensation.

(3)
Beginning on July 1, 2005, the board shall provide that the plan
include coverage for hyperbaric oxygen therapy for children with cerebral
palsy. The benefit provided in this subsection
shall be subject to the same annual deductibles or coinsurance established for
all other covered benefits within the plan.

(4)
(a) Schedule of life insurance
benefits--group term: The amount of
term life insurance for each active employee of a department, agency or
institution of the state government shall not be in excess of One Hundred
Thousand Dollars ($100,000.00), or twice the amount of the employee's annual
wage to the next highest One Thousand Dollars ($1,000.00), whichever may be
less, but in no case less than Thirty Thousand Dollars ($30,000.00), with a
like amount for accidental death and dismemberment on a twenty-four-hour basis.

(b)
Effective October 1, 1999, schedule of life insurance benefits--group
term: The amount of term life insurance
for each active employee of any school district, community/junior college,
public library, university-based program authorized under Section 37-23-31 for
deaf, aphasic and emotionally disturbed children, or any regular nonstudent bus
driver shall not be in excess of One Hundred Thousand Dollars ($100,000.00), or
twice the amount of the employee's annual wage to the next highest One Thousand
Dollars ($1,000.00), whichever may be less, but in no case less than Thirty
Thousand Dollars ($30,000.00), with a like amount for accidental death and
dismemberment on a twenty-four-hour basis.
The plan will further contain a premium waiver provision if a covered
employee of any school district, community/junior college, public library,
university-based program authorized under Section 37-23-31 for deaf, aphasic
and emotionally disturbed children, or any regular nonstudent bus driver
becomes totally and permanently disabled before age sixty-five (65) years.

(5)
Any eligible employee who on March 1, 1971, was participating in a group
life insurance program that has provisions different from those included in
this section and for which the State of Mississippi was paying a part of the
premium may, at his discretion, continue to participate in that plan. The employee shall pay in full all
additional costs, if any, above the minimum program established by this
article. Under no circumstances shall
any individual who begins employment with the state after March 1, 1971, be
eligible for the provisions of this paragraph.

(6)
The board may offer medical savings accounts as defined in Section 71-9-3
as a plan option.

(7)
Any premium differentials, differences in coverages, discounts
determined by risk or by any other factors shall be uniformly applied to all
active employees participating in the insurance plan. It is the intent of the Legislature that the state contribution
to the plan be the same for each employee throughout the state.

(8)
On October 1, 1999, any school district, community/junior college district
or public library may elect to remain with an existing policy or policies of
group life insurance with an insurance company approved by the State and School
Employees Health Insurance Management Board, in lieu of participation in the
State and School Life Insurance Plan.
On or after July 1, 2004, until October 1, 2004, any school district,
community/junior college district or public library may elect to choose a
policy or policies of group life insurance existing on October 1, 1999, with an
insurance company approved by the State and School Employees Health Insurance
Management Board in lieu of participation in the State and School Life
Insurance Plan. The state's contribution of up to fifty
percent (50%) of the active employee's premium under the State and School Life
Insurance Plan may be applied toward the cost of coverage for full-time
employees participating in the approved life insurance company group plan. For purposes of this subsection (8),
"life insurance company group plan" means a plan administered or sold
by a private insurance company. After
October 1, 1999, the board may assess charges in addition to the existing State
and School Life Insurance Plan rates to those employees as a condition of
enrollment in the State and School Life Insurance Plan. In order for any life insurance company
group plan to be approved by the State and School Employees Health Insurance
Management Board under this subsection (8), it shall meet the following
criteria:

(a)
The insurance company offering the group life insurance plan shall be
rated "A-" or better by A.M. Best state insurance rating service and
be licensed as an admitted carrier in the State of Mississippi by the
Mississippi Department of Insurance.

(b)
The insurance company group life insurance plan shall provide the same
life insurance, accidental death and dismemberment insurance and waiver of
premium benefits as provided in the State and School Life Insurance Plan.

(c)
The insurance company group life insurance plan shall be fully insured, and
no form of self-funding life insurance by such company shall be approved.

(d)
The insurance company group life insurance plan shall have one (1)
composite rate per One Thousand Dollars ($1,000.00) of coverage for active
employees regardless of age.

(e)
The insurance company and its group life insurance plan shall comply
with any administrative requirements of the State and School Employees Health
Insurance Management Board. If any
insurance company providing group life insurance benefits to employees under
this subsection (8) fails to comply with any requirements specified in
this subsection or any administrative requirements of the board, the state
shall discontinue providing funding for the cost of that insurance.

SECTION
2. This act shall take effect and
be in force from and after July 1, 2005.